Wednesday, August 1, 2012

Electronic Cigarette Review: E-Cigarettes are here to stay

A recentelectronic cigarette reviewby the web site WebMD asks the rhetorical question, “Are E-Cigarettes Here to Stay?” The author makes a rather clever point that “Electronic cigarettes are picking up steam...” She refers to a recent study in the American Journal of Public Health” that highlights a growing public awareness of electronic cigarettes among the American public (about 40%, according to their survey).

Stating the obvious

Who are more likely to use e-cigarettes? Wouldn’t that be existing smokers? That is what the study found, and yet the piece seems to express a surprised curiosity over that fact. Of course existing smokers would want to use electronic cigarettes, which contain about 3,998 fewer ingredients than burning tobacco. A novice smoker (say a teenager) doing an impromptu electronic cigarette review, would probably rather light up and blow real smoke than the wimpy steam e-cigarettes emit and would probably not “graduate” to e-cigarettes until hooked on nicotine.

Perhaps the author has never smoked and gone through the difficult withdrawal from nicotine, and like so many antismoking advocates just does not understand how difficult it is to stop puffing on toxic cancer sticks. Now that e-cigarettes are on the market to throw a lifeline to both the poor smokers and nonsmokers harmed by secondhand smoke, it seems that antismoking forces are (ironically) opposing a product that doesn’t foul the air and has proven to be a smoking cessation tool.

Not marketed that way, though

The article says that e-cigarettes aren’t regulated by the FDA “as a drug delivery device because they are not marketed as quit-smoking aids.” That is a somewhat misleading statement. The FDA actually tried to regulate e-cigarettes as a drug delivery device but lost their case in court. It wasn’t the FDA who decided that e-cigarettes are not marketed as quit-smoking aids. The court ruled that e-cigarettes were, similar to cigarettes, nicotine delivery devices and should be regulated like cigarettes. The FDA still has not come out with definitive regulations on electronic cigarettes – perhaps because they should not be regulated exactly like real cigarettes?

Specious “unknowns”

Then the article cites several "unanswered questions" about the safety of e-cigarettes, which any smoker could readily answer:

•Do e-cigarettes encourage former smokers to take up smoking again and “re-ignite their nicotine addiction?” Any ex-smoker knows the danger and undesirability of resurrecting a habit that was so very tough to defeat. The existence of electronic cigarettes would not factor into a decision to get re-addicted to a drug they worked so hard to kick.

•Are people who smoke now using electronic cigarettes to quit or to get around indoor smoking laws? So what? Whichever reason applies, quitting or keeping the air free of harmful cigarette smoke would both be good things. If the smoker is not interested in quitting but wants to keep smoke out of the air, that’s one less cigarette inhaled into the lungs and one less butt discharged into the environment. Besides, strictly speaking, electronic cigarette reviews need to take into account something very important about their nature: e-cigarettes are harm reduction devices that, at the very least, mitigate the harm of smoking, and, at best, could be used to stop altogether.

•Finally, how are electronic cigarettes affecting nonsmokers who have never smoked? Are they “gateway products?” The answers are undoubtedly: (1) not at all, given the minute traces of stuff in the steam exhaled by e-cigarette smokers, and (2) the “gateway” to cigarette smoking would more likely be the single cigarette from the $5.00 cigarette pack and not the costlier electronic cigarette kit or disposable kind.

FDA, et. al, want a perfect world with lousy options.

So antismoking advocates continue to urge “greater regulation of these products until these questions are answered.” In the meantime, the FDA continues to urge people wanting to quit use approved “smoking cessation tools” (nicotine gum, patches, lozenges), which, unfortunately have about a 90% failure rate.

One voice of reason

The article ends on a more balanced note citing one voice of reason: physician, Michael Siegel (associate chairman of community health sciences at Boston University School of Public Health) who points out the obvious fact that if electronic cigarettes were taken off the market “smokers would be forced to go back to cigarette smoking.”

The real question about FDA's electronic cigarette review

Do the FDA and their antismoking colleagues really want smokers to go back to blowing smoke? Or is the "smoke blowing" being done on behalf of the pharmaceutical companies who market "approved" smoking cessation devices?